MegaSack DRAW - This year's winner is user - rgwb
We will be in touch
Ok [b]Grum[/b]
That was indeed the one. And I'd mentioned it too.
1) Only covered 19 countries
2) Finished in 2005
3) At the time it finished. UK NHS spend was only 7.1% of GDP, by 2009 it was 9.3% and rising. Has then NHS become 31% more efficient over that 4 years? And the cost has gone up since...
4) The metrics used were very limited - not including anything happening to people over the age of 74...
5) The discussion at the end certainly flags up the limitations.
We could look at Cancer mortality where we do pretty poorly. Or CHD where we have done rather well. Main thing is the US system sucks.
Stoatsbrother - MemberSo how do we fix broken services run by complacent clinicians and obstructive managers, where patients have their appointments cancelled 7 times in a row, and get no apology, where there is no other provider within 20-30 miles...
With high quality professional management and democratic oversight 🙂 There is no excuse for poor performance like that.
If thats your diagnosis of what is wrong I can happily agree that that is an issue and a very difficult one. I can accept your experiences mean you see some use in using the private sector. The examples you give - got any links / hard data - I would really be interested. I bet its more expensive than the best practice in the NHS and / or its providing less of a service
An little anecdote about competition. Its generally thought of in financial terms - however as an example of non financial competition. years ago the hospital I worked in had no queues for hip replacements - why - cos the two consultants had a friendly competition running to see who could have the shortest list.
Their are many ways of driving down costs and improving outcomes. Simply using a private provider instead of a state one does not necessarily lead to improvements, infact the experience generally across the UK is the other way round.
Ok GrumThat was indeed the one. And I'd mentioned it too.
So there are some issues with the study - meaning that it is completely wrong and the opposite is true, the NHS is actually terrible? Where is the evidence for that - because everything I have seen on this thread about how dreadfully inefficient the NHS is has been completely anecdotal.
TJ - you almost got it:
Simply using a private provider instead of a state one does not necessarily lead to improvements,...
but...sigh....
..in fact the experience generally across the UK is the other way round.
😉
So why do huge private companies outsource certain functions - catering, for example? Why should the NHS be any different? Or is there really nothing you could more efficiently provide with private contractors?
Why should the NHS be different? Healthcare can never be a market as choice simply is not possible. When I am in hospital I cannot make a choice as to who is going to provide my meals and also that teh NHS must and should have other priorities than cost. Such as quality, responsivness, control and so on.
[b]grum[/b] - I am saying the NHS is good, but not great, and could be better. I have spent a lot of time trying to get it to be better locally, at both a micro and a macro level. We cannot afford to be complacent.
We need to look at the message from that study - which is that in those two limits metrics of mortality - the UK isn't doing badly - but there is so much more we can do. If you want to dig out some other cost-effectiveness stuff you will see slightly different results.
[b]TJ[/b] wish I could give you the specifics of two very concrete examples of how we improved one local surgical speciality's performance by shifting temporarily some activity privately and by commissioning changes we made. I suspect I'd be up before the GMC for "disparagement" if I did. The Hearing aid and optometry services I mentioned are commissioned at the same price/cheaper. Many hospitals already contract out chunks of cross-sectional imaging to private providers at the same tariff.
For all your hopeful statements that with the right management things can get fixed, often the management and the consultants just are not willing to change. They do not take a view of their service wider than the task they are doing at that second. Again I could name a service I have been trying to work with in developing clearer access pathways - but nothing happens. They have no incentive to change.
TJ - again you are asking the wrong question. It is not about choice of lunch - that is absurd.
Under the current system, choice is available BUT only if you can afford it. For routine operations, you can chose your doctor, have flexibility on timing, go to a comfy hospital with a nice (clean) room and have tasty food to eat etc....(but the latter is not the swing factor!!). And there are plenty of examples on this thread of the provision of choice to prove it.
1. Explain why the structure of the NHS failed right from its early days (please see my earlier post)
It hasn't. It has provided us with cheap high quality healthcare
2. Explain how, against all theory and most practice, a monopoly supplier can be a more efficient supplier of scare resources that one that is subject to competition
It just does. No matter how much you wish otherwise thats the direction the evidence points. Dunno what theory or practise you refer to
3. Explain why most people who can afford to, will choose private versus public sector suppliers of health, education etc. Are they mad? Or do they recognise that they can pay for a better service(albeit probably not in the case of genuine emergencies)?
Most people? I know plenty of folk who could afford private healthcare and don't. Anyway private healthcare is only a small topup on NHS care. Much stuff you cannot get privately.
got any evidence to back that up?
Stoatsbrother - MemberAnyway - I know my place - I'm not a big hitter so I'll scurry back under my rock.
Dinnae dae that - its interesting
TJ have you ever considered your posting style might be slightly counterproductive? Just a thought. And you do seem to get more angry and your argument more disorganised.
I am a bit disorganised right now - too many early starts / short nights.
TJ - I am all for debate, but this dogmatic style and continuation with the "any evidence" line when plenty has been given is frankly tiresome.
I will retire gracefully as this continues to focus on the wrong question anyway...
...now where was my bike?
often the management and the consultants just are not willing to change. ........They have no incentive to change.
They have to be given the incentive. it does not have to be financial. Why are some NHS units so much more efficient than others? Why are some areas so much better than others?
Over the last few years where I have seen large chunks of Lothians healthcare I have come to the conclusion that is poor quality management is the main issue. We need higher calibre people/ better training of the managers. Private and NHS. the best mangers make a huge difference. it matters not one jot about their background - good managers make for good services.
So in the specifics of the failing service you mention - the people involved must be held accountable. Their responsibility is to run the service - sack 'em if need be and get power as far away from consultants as possible.
Its a management failure that leads to a poor service - and I have seen this in private healthcare as well
teamhurtmore - MemberTJ - I am all for debate, but this dogmatic style and continuation with the "any evidence" line when plenty has been given is frankly tiresome.
Plenty? I have seen none at all.
Its a bit tiresome to be asked to back up your claims isn't it.
here is some stuff about the failings of NHS contracting out services
http://www.timesonline.co.uk/tol/life_and_style/health/article6843637.ece
Teamhurtmore. - you expect me to accept a document from Reform as evidence?
And who sacks them?
If the chief exec doesn't see a problem and improving the service might reduce the trust's income? I could give you details of our local trust's last 2 chief execs which would intrigue you - but lead to a lawsuit... I even did a FOI request on one's severance package. £540,000 I think it was. And the next one banned me from speaking to her team, because I was looking at how expensive one service was.
Just remembered another example - we looked at anticoagulation services for which an extortionate rate was being changed. We saved a 7 figure sum per year just by looking closely enough. We then saved another 6 figure sum per year by shifting most of it into Primary Care where we have a cheaper service, closer to patients, with better IT allowing better audit and quality assurance. Yet another bit of evidence.
The way you show a bad shop you are unhappy is by telling them once or twice, then shopping elsewhere. Otherwise they do not change.
I think your charming statements about how you can change things are as robust and realistic as a Miss World's aspirations for world peace.
Bottom line - things have moved on. I am anti handing the keys to everything to outside conglomerates, even though both Labour and Conservatives have flirted with it. But there are things to be learnt from private/independent providers. Your polemic stance is 10 years too late, and ignores the benefits of an open mind about these things.
Why should the NHS be different? Healthcare can never be a market as choice simply is not possible. When I am in hospital I cannot make a choice as to who is going to provide my meals and also that teh NHS must and should have other priorities than cost. Such as quality, responsivness, control and so on.
You're confusing customer choice and an open bidding process that leads to a private service provider - I'm talking about a hospital (or trust) requesting tenders to provide a service, for a given maximum price, with a given set of characteristics - in this case a minimum number of meal options, vegetarian, low / zero salt, etc., 24x7 service, etc. Once the bidding process is over that one provider would run the hospital catering service. I'm not talking about patients deciding which caterer they fancy on a given night!
OMG! The linking to articles and overuse of quotation boxes has started, this is getting serious now.... I'm out before I get sucked in and lost forever...
Mogrim - I am confusing nothing. I am pointing out the limitations.
If a supermarket say outsources its catering I can choose to eat there or not. I do not have this choice in hospital - therefore I do not have the ability to reject the offerings. A captive market. Quality does not matter to the catering company as there is no financial penalty of dropping sales if quality is poor.
As for contracting out catering services in the way you describe - I have never seen it work and I have seen it tried many times - always the quality is appalling or the cost is high. Basically if you give them the NHS budget for providing meals a contracted out caterer cannot provide cooked from fresh on site for that cost. The result is bulk produced cook chill systems and a complete lack of flexibility along with god awful quality. Have you ever eaten a cook chill omelette? its disgusting.
perhaps it can be doen better but my experience is that cooked from fresh on the premises is the only aceptabel way and a contracted out service cannot do this withig the budgets
perhaps it can be doen better but my experience is that cooked from fresh on the premises is the only aceptabel way and a contracted out service cannot do this withig the budgets
I've not seen NHS subcontracted caterers, but I've been to lots of Spanish ministry canteens run by private companies, and they're cheap and have perfectly acceptable quality.
edit:
Quality does not matter to the catering company as there is no financial penalty of dropping sales if quality is poor.
You need to include an objective quality measure as part of the contract.
Not going to work mogrim, if it hasn't happened in Tandemworld, it hasn't happened.
Quality does not matter to the catering company as there is no financial penalty of dropping sales if quality is poor.
Can someone tell me how that works?
Cooked from fresh on site? thats the key - I have had contracted out catering in a private unit - that was good as it was cooked from fresh on site - more expensive than the NHS catering it replaced tho ( which was offsite and awful).
Why would the contracted out service be cheaper? - its costs are the same - staff wages ( unless it forces wages costs down) and ingredients and the private one has to pay a profit to someone and has higher management costs. a decently run non profit making system will always be cheaper - the challenge is to run them well.
Can someone tell me how that works?
Year-on-year improvement in patient surveys would be one way.
objective quality measure
Very difficult to do and to build in meaningful penalties. You will be fighting the pressures to reduce quality constantly
Why would the contracted out service be cheaper? - its costs are the same - staff wages ( unless it forces wages costs down) and ingredients and the private one has to pay a profit to someone and has higher management costs. a decently run non profit making system will always be cheaper - the challenge is to run them well.
Definitely, which is why a private company serving 30 hospitals is likely to be cheaper than part of a single hospital serving just that one. Not sure why management costs would be any higher, though.
Again the issue here is that a private provider may be more motivated to manage the quality and delivery of a catering or other hotel service if it is on a three or five year contract with quality control than a legacy directly NHS employed catering department who feel at no risk of their jobs whatever what ever they serve up.
Some of the mankyist food I have had had been at NHS hospitals. Some of the best in Australia.
mogrimDefinitely, which is why a private company serving 30 hospitals is likely to be cheaper than part of a single hospital serving just that one
Why - where is the saving to be made? The NHS already has the benefits of economies of scale,
Because its more complex management costs will be higher and you loose the economies of scaleNot sure why management costs would be any higher, though.
Stoatsbrother - so the answer is to manage the NHS system properly.
Why would the contracted out service be cheaper? - its costs are the same - staff wages ( unless it forces wages costs down) and ingredients and the private one has to pay a profit to someone and has higher management costs. a decently run non profit making system will always be cheaper
Any answers to where the saving is supposed to come from?
Your polemic stance is 10 years too late, and ignores the benefits of an open mind about these things.
Remember Scotland does not have the stupid nuLabour bollox - we didn't adopt any of that and merely undid the worst of the freemarket nonsense the tories put in.
Its still not too late in England - You are incredibly naive to not understand how fundamental this proposed change is.
we didn't adopt any of that and merely undid the worst of the freemarket nonsense the tories put in.
coughcoughtramscoughcough....
😉
Just don't CFH or I'll mock your rugby team
Yeah, good point. Taking cheap shots is too easy! 🙂
a decently run non profit making system will always be cheaper
Theoretically you are right and you appear to be using a theoretical argument to support a very different reality.
That is perfectly logical as if all things are equal a non-profit organisation is going to be cheaper than it's profit making counterpart.
Making the question quite redundant.
Any answers to where the saving is supposed to come from?
Would a profit making private company be cheaper and more efficient than the current publicly funded inefficient non-profit making system is the question you should really be asking.
Hmmm, 9 pages. Is it worth a read?
thegreatape - MemberHmmm, 9 pages. Is it worth a read?
Wadday think? Lots of hot air and hard data is in very short supply.
I was thinking from an entertainment rather than educational point of view.
@ CPT
1 - It's seen as herecy to posit the idea that there could be some benefit to change within the NHS
is it? People seem to be objecting to the change not change per se.
2 - Anyone who even considers such a change is an evil privateer (Nice use of the word, there!) and wants to rapaciously slash and burn their way to a profit by taking the state out of the NHS
no of course not they seek to profit from healthcare because they are great humanitarians and want to give something back it's an act of philanthropy 🙄
3 - There is an incorrect assumption that somehow the this will be total NHS Privitisation (sic), when in fact it would be looking at ways of making improvement
it would be privatising some though and you have given nothing to explain why this would be an improvement.
4 - Looking at ways of making improvements is apparently evil
etc. etc. etc.
Who said that?
Stick to the pithy comments your arguments are quite weak and largely consist of misrepresenting others views rather than explaining why your view is so good or why or how competition will help.
Na- stoatsbrother and I started to exchange insults but non of it was very inventive
Ok cheers
We have been facing proposed changes likes this for 10 years. Some of the anti rhetoric is straight out of the 1970s.
Just saying the NHS [i]should[/i] be well managed is pointless. It often isn't. There isn't the medical management hierarchy system there is in many countries, and getting rid of poorly performing Consultants and managers is near impossible.
In the end the only way to change somethings is to open a competing shop, and see what happens then.
In the end the only way to change somethings is to open a competing shop, and see what happens then.
You keep claiming this - however there is no evidence that this is so - infact the evidence is the other way. Private healthcare is more expensive for poorer outcomes no matter how you compare it.
We have been facing proposed changes likes this for 10 years.
balderdash - this is far more fundamental - you are either naive, deluded or mendacious to say that.
Back to your usual quality of debate. 😉 Do you wonder why people take the mickey? When you argue with people who actually know something about the subject you are pontificating about and who challenge your view, you dig in and get nasty. Bit of a flaw eh?
Thing is I met Simon Stevens before he worked for Tony Blair and United Health. And read the White papers. And followed the debate and rhetoric. If this is new to you, you are a bit out of touch.
Anyway. Really will leave this thread now. No point in discussing it with you. You just never ever listen. 🙂
Nicely played, but there's still time for the Edinburgh defence. 😯
10 pages of debate, no consensus as to best system, no attempt to suggest how we het there from here.
UK healthcare debate in a nutshell, lots of shouting, absolutely no result.
DS why ?
Goading someone who cannot read your posts is both childish and moronic. It is not likely to make him read now is it?
Why bother?
My wife who has been working for the NHS for 10 + years as a nurse has just been told all the nurses within the Berkshire trust are getting a pay cut!!
I can't discuss it with her as I am so annoyed.
Junkyard - MemberDS why ?
Goading someone who cannot read your posts is both childish and moronic. It is not likely to make him read now is it?
Why bother?
Why what?
Which message do you think I have written is directed at TandemJeremy and goading?
Do you consider [s]sticking your fingers in your ears and going Lalalalal[/s] using killfile to ignore people as being adult and not moronic? The reasons behind using it a bit hypocritical?
Do I give a s**t what TJ thinks in general or about me? Ja no!
I think you're a decent chap Junky, I've never met you, but I think you're a decent chap.
I've never met TJ but I think he's a narrow minded hypocrit based on his writings here.
Scotland. Appallingly unhealthy people, unreformed healthcare subsidised by England. Your welcome.
Scotland. Appallingly unhealthy people, unreformed healthcare subsidised by England.
*Blue touchpaper is lit.....*
*Retires to a safe distance. *
Oh, and Don Simon, +1.
I think you're a decent chap Junky, I've never met you, but I think you're a decent chap.
now you are back we may meet up and I can disprove this unfounded rumour.
If I like you I will tell you who is on my list 😉
I might do that for some professional input. Where are you based? Man U fan so I guess down south, no? 😉 You're north of Manchester, correct?
I don't know what point you think you are making about Blair? I protested about his changes as well where they were stupid and damaging
I have followed the debate and the rhetoric thats why I know this is a fundamental change. You really consider this to be incremental? the government not having the responsibility for ensuring the comprehensive coverage? The right for private companies to cherrypick on favourable terms? the lack of any duty on them for continuity of care? Allowing private companies to decide on who is the provider for certainparts of the service? removing and system of accountability and checks and balances?
Its an utter nonsense. Do you really want a situation where a healthcare provider can go bust and leave a section of society to be without care? heard of southern cross have you?
Stoatsbrother. Yes you have a good knowledge of a part of the picture. I have another part. What understanding do you have of running large institutions with hundreds or thousands of staff for example?
I have repeatedly asked for any evidence that for profit healthcare provides either better outcomes or saves money - you have asserted about some small specialised services and I have been offered a fringe right wing thinktank pamphlet. No evidence has been offered especially with regard to large scale acute work.
I am sorry - I do actually respect your knowledge and I wish you could provide something for me to look at about the stuff you assert but in the absence of any evidence that these changes will mean anything other than significant damage I consider your case falls
crikey - Member10 pages of debate, no consensus as to best system, no attempt to suggest how we het there from here.
UK healthcare debate in a nutshell, lots of shouting, absolutely no result.
Ok - my view - we take the best of what we have now. Add to that a drive for high calibre professional management.
Remove the stupid bits recent reorganisations - foundation hospitals and so on.
strengthen local accountability in a broad based way, remove power from politicians.
Look to other systems and see what they do better. Look to the best bits of the NHS and learn from that to improve the failing bits.
Really good quality financial information available in a transparent way - use peer pressure, public pressure to drive forward cost efficiency as well as improving outcomes.
Look to other systems and see what they do better. Look to the best bits of the NHS and learn from that to improve the failing bits.
And, if any of those other systems used private means to do better, I believe that you would oppose any move to "learn" from them on ideological grounds regardless of the potential for improvement.
FWIW, the above notwithstanding, I agree with the rest of your post. I may disagree with how we achieve [i]"a drive for high calibre professional management"[/i] and [i]"drive forward cost efficiency as well as improving outcomes"[/i], but these are the things that are needed.
As long as it's uncharged at the point of use I don't care who runs it. I do care that it improves from the organisation as it stands, though I do understand that it will be very difficult with the sort of fixed views expressed by some of the vested interests and political positions in the last 10 pages. I supose the first thing I would ask all the stakeholders, what the NHS is for, then what is it's most important function? That would be my start point.
It's very clear that UK healthcare is adequate but not as good as it could be, but its also clear that any attempt at reform is complicated by the political football thing that the NHS has become. Uncanny parallels with the debate in the usa.
I think it needs us to swallow our pride, put aside our politics and really try to be as impartial and open minded as we can.
It's a challenge, we shall see if we, as a nation are equal to it.
CFH - I would take anything that works.
there is no doubt that one of the things that thatchers transfer of long term elderly care to the private sector brought was vastly improved choice and hotel care. Nursing care is a lot poorer and costs are high tho and its a rigged market. Its an unintended corollary mainly tho - its the independent inspection regime that drives most of the improvement.
Truely independednt regulation / inspection of the NHS with a lot more power would help greatly - the care home regulators can close units and require new managers for example
I would take anything that works.
I sincerely hope that [i]if[/i] it is proved that some element of private enterprise working [i]with[/i] the NHS [b]works[/b] that you would take that. I still feel that you would oppose it on ideological rather than practical grounds, but I would very much hope to be proved wrong.
Rather an interesting, if legalease based, read. Of course, as it's on ConHome, it will be dismissed as being from tehevaltoryscuminnit. However, worth a read.
strengthen local accountability in a broad based way, remove power from politicians.
so who will represent the local community? you know as well as I do it with be stoogies from the main parties and those from well organised single issue pressure groups
or do you propose we draw lots?
That is the aim of this reform. Don't be mislead. Its to allow American private for profit healthcare companies to take NHS contact
Why are you agitated about it being American companies that would be engaged in provision of healthcare services? You and others have mentioned it quite a few times but capital is stateless.
When I am in hospital I cannot make a choice as to who is going to provide my meals
Again - this is just as much a straw man as the "do we expect people to choose between A&E departments in the back of an ambulance" toss above. The choice to be made between competing providers would be made by the hospital/trust itself - so for example the contract to provide catering to patients would be put out to tender, it's not the patients themselves that would get to choose.
This is exactly parallel to how it operates in the private sector: if I'm an employee of a company that has outsourced estate services, it doesn't mean that I individually have to make a choice about who fixes a broken window - the company has already chosen.
Whether you think that's a good way to operate or not, you don't have to make stuff up.
Konabunny - the point is you have a captive client group as a private supplier of food to the NHS. It is not how it works in the private sector where the people eating the food have achoice of going elsewhere.
thus it can never operate as a market - so has to be regulated. this means the only incentive on the caterer to keep up quality is thru the regulatory process - so its going to be a constant battle to keep quality up and this regulation has an additional cost that is not small.
Treating the NHS as a commercial outfit can never work, the priorities are not the same, its a natural monopoly and a market can never work in healthcare if you have universal provision
Again - this is just as much a straw man as the "do we expect people to choose between A&E departments in the back of an ambulance" toss above.
If you're referring to my earlier posts about 'choice'- nice straw man argument of your own there. 😆
Whether you think that's a good way to operate or not, you don't have to make stuff up.
Konabunny - the point is you have a captive client group as a private supplier of food to the NHS. It is not how it works in the private sector where the people eating the food have achoice of going elsewhere.
But surely by opening up public sector industries to the private sector you are going to introduce a new concept of choice.
Am I forced to go to my crappy hospital in N. Shrops or can I now take my money across the border to Wales?
It's the fear of public workers that is stifling change and progress.
Clients > Patients.
What do I win?
for most this competition myth is not that easy or as plausible. I stand in a town centre hungry I have many eateries to choose from so competiiton is excellent for me in increasing choice and driving down costs
If I have a heart attack in said town centre the choice of hospitals is less relevant as what I need is the nearest one to be good enough for me to not die when i Get there.
I may be better able to decide which foosd I like the taste off than i am able to assimilate clinical studies of various hospitals mid caerdiac arrest to make an informed choice. It is not like we can hospitals side by side delivering everything and i choose where to go.
Why are you agitated about it being American companies that would be engaged in provision of healthcare services? You and others have mentioned it quite a few times but capital is stateless.
Perhpas it is because they are just foreigners over here to take our money away [ tax payers money obviosuly] in profit and perhaps this angers people? You seem to think stateless capital is something we should not be annoyed by Why?
"It's the fear of public workers that is stifling change and progress"
Very much this.
Most patients couldnt actually give a toss who provided their care as long as it was of a good quality and continued to be free at the point of need....there will always be a few passionate individuals that lean one way or another but the masses are largely disinterested.
As said in somebody else's post, certain public sector workers (who unfortunately tend to be in positions of influence and management) know they would be out of a job if a private firm took over an A&E for example and saw just how many 'suits' were taking up space (and wages) without actually contributing anything to patient care.
It is usually these parasites that whip up the outrage about privatisation of the NHS....front line staff in my trust have for many years known it is coming and the privatisation of non emergency work was observed at close quarters about a decade ago and about 2 years ago private firms started providing supplementary ambulances to help out with emergency work too....the staff are no different to us in the NHS, the service offered to the patient hasnt changed, they carry the same kit and drugs that NHS ambulances carry.....they are however massively cheaper for the Primary Care Trust to use due to a lack of overheads our NHS trust can only dream about.
I honestly believe that tendering contracts to the private sector will be a good thing....even if the private firms bidding for a contract dont get it then it will hopefully have the much needed side effect of forcing the NHS to buck its ideas up to stay competitive.
It's the fear of public workers that is stifling change and progress
Agree, and not just in the NHS. To many people in public sector work worry about their own interests and stifle progress imo.
If I have a heart attack in said town centre the choice of hospitals is less relevant as what I need is the nearest one to be good enough for me to not die when i Get there.
And this is, of course correct, and widespread privatisation would be a bad thing.... Or would it? If privatisation improves services across the board you wouldn't have to worry about the choices being made on your behalf as ALL the service providers would be of an acceptable level.
The danger being that, like the food, there is a likelyhood of saturating the market in an attempt to grab a share and the lack of imagination in an attempt to make sales has the unique result of driving down quality. As long as the customer is driving down prices, the quality will be driven down too.
Deiviant - so much is wrong with that post that its not worth bothering with really.
Its not the workers unfounded fears thats stifling change - its the justified fears that the service provided will get worse. Evidence based practice is the mantra -= whereis your evidence?
As for overheads - once again - find some facts. Eavy I have seen analysied the privte firms overheads anre higher and so are the costs when you atully look at like for like. This is a necessary corollory of the system - the profit has to come from somewhere and unless you either cut wages of cut staff levels then there is no saving to be made.
The NHS is proven to be more efficient than private healthcare with lower overheads and management costs.
Once again - has anyone any shred of credible evidence that for profit healthcare providers either reduce costs or improve outcomes?
I have been asking for this and been furnished with none
si_progressivebikes - MemberIt's the fear of public workers that is stifling change and progress
Agree, and not just in the NHS. To many people in public sector work worry about their own interests and stifle progress imo.
Evidence?
its a classic bleat from the right wing who do not understand the public service ethos
Evidence?its a classic bleat from the right wing who do not understand the public service ethos
LOL, right wing am I? My wife works for a local Auth at reasonably strategic level, the stories I hear about staff protectionism/ inefficiency is quite frankly outrageous. It may, may not be the same in the NHS.
its a classic bleat from the left wing who do not understand the private sector ethos
ftfy
public service ethos
What Ethos? What a load of rubbish, like the public sector breeds a certain type of philosphy to work and provision!
One only has to look at Staffordshire general hospital where patients where allowed to die due poor management ,chasing targets, most of the management who have now gone have gone on large payoffs, and harold shipman, who was allowed to get away with murder, because nobody questioned his failure rate, amongst patient dyeing.
and there are a lot more cases soon to be exposed of poor management,even if services are privatised these same useles managers are still in a job.
Si - getting into local authorities is another thing altogether. I've worked for 2 local authorities on a brief freelance basis and was genuinely absolutely gobsmacked by what I saw.
public sector breads a certain type of philosphy to work and provision!
Unfortunately it does precisely that.
Local Authority Public Service ethos = unemployable, bone-idle, workshy half-wits, who frankly wouldn't last until lunchtime in the private sector, sat around doing absolutely **** All, all day!!
I suspect they wouldn't get away with it in the health service
Once again - has anyone any shred of credible evidence that for profit healthcare providers either reduce costs or improve outcomes?
I think that non-profit making providers are destined for failure as inflation passes them by and pushes them into loss making.
TJ I find that most of your arguments are chopping and changing to suit you own end that
so much is wrong with that post that its not worth bothering with really.
If you really struggle to understand how introducing privatisation into some, not necessarily all, areas of healthcare, I suggest that you do some research rather than blocking out the opinions that conflict with your own and might help you learn and understand.
If privatisation improves services across the board you wouldn't have to worry about the choices being made on your behalf as ALL the service providers would be of an acceptable level.
That is a big IF and is this not what we have now but without the private bit? Currently a large hospital can do everything. Imagine I went to say a caerdiac unit that was private and then i need to transfer to somewhere else due to complications that they dont deal with - who pays and we need adminstrators to discuss whether the private company made errors and how much they pay etc. it just depnds tbh it may be better it may be more efiicient it may not. However I dont see how adding another layer to the NHS and private companies magically makes it less beurocratic or cheaper
"It's the fear of public workers that is stifling change and progress"Very much this.
Most patients couldnt actually give a toss who provided their care as long as it was of a good quality and continued to be free at the point of need
I disagree and I think you will find most people love the NHS and want it to remain free from private influence and control as well as free at the point of delivery.
As for blaming public sectors workers for this it is just a right wing BS polemic. Any worker anywhere will think about how change affects them but the resistance to change in the NHS is not just due to "fear" - WTF does that even mean in theis context?. Even the BMA and RCN were/are resistant to the current change and they are hardly left wing organisations or known for being scared of change.
It would only be progress if it improved things so at this point better to say change than progress. Very few public sector employees DONT want things to get better whatever you seem to suggest. I doubt you can evidence this anyway and generally all employees dislike change be they public or private sector workers
DS yes North of manchester if you are in the area or doing the Lakes give me a shout - obviosuly once you have acclimitised to the weather 😉
Brilliant - I thought for a moment the t'internet had thrown a wobbly and diverted to a Dickensian kindle by mistake 🙂TJ wrote
balderdash - this is far more fundamental - you are either naive, deluded or mendacious to say that.
I also can't believe you are so dismissive of Stoatsbrother as he quite evidently (to use your favourite word) knows what he is talking about. Also, Deviant has made valid points about costs in the private sector. If you want evidence, come along to my ambulance station and chat to the bank paramedics who are on double my hourly NHS rate, or the local A+E where 'bosses' frequently outnumber doctors and nurses while patients are lined up in the corridor for hours waiting for basic treatment.
To many people in public sector work worry about their own interests and stifle progress imo.
like the public sector breeds a certain type of philosphy to work and provision!
which one are you arguing now?
They think and act alike or they dont ?
Once again - has anyone any shred of credible evidence that for profit healthcare providers either reduce costs or improve outcomes?
i have two main hospitals that refer forensic patients to me... one private (priory group) and the other is pure old fashioned NHS.
the priory one is superior in every respect, staffing, risk assessments, quality of paperwork, communication, training, patient interaction, therapeutic activities and opportunities, extended outreach, aftercare... etc etc.
EDIT - phwoarhundereddddd